title: Application of a peripheral nerve block technique in laser treatment of the entire facial skin and evaluation of its analgesic effect.
abstract: BACKGROUND
  The aim was to develop a technique for peripheral nerve block anesthesia (PNB) for the skin of the entire face and neck, considering the nerves anesthetized, injection sites, use of an injection method assisted by computer-controlled local anesthetic delivery (CCLAD), and to evaluate the analgesic effects of the PNB technique.
  
  
  METHODS
  50 patients who suffered from large nevus of Ota lesions or port-wine stains on their facial and neck skin and who required laser treatment were included. This study was designed as a non-randomized self-control trial. All the patients received the laser treatment under topical anesthesia in the first phase and three to six months later, they received the same treatment under the PNB using CCLAD. The differences in scores from the visual analogue scale of pain for the two phases were analyzed by the t-test. P values <0.05 were considered to be statistically significant.
  
  
  RESULTS
  The peripheral nerve block technique was simple to execute and easy to learn, the anesthetic injection site was generally located at a subcutaneous depth of 0.5-1.0 cm. The analgesic effect of PNB was significant, the mean pain score (2.8 ± 2.2) was significantly lower than that with topical anesthesia (P<0.0001). Patients during the PNB phase did not experience injection pain following CCLAD.
  
  
  CONCLUSIONS
  The peripheral nerve block technique can greatly ease the pain that occurs during laser treatment, especially for patients with larger lesions. CCLAD will allow PNB to be broadly applied in laser treatments.
authors.affiliation: Dental Department.
authors.forename: Kuo
authors.initials: K
authors.lastname: Wan
authors.affiliation: Dental Department.
authors.forename: Quan
authors.initials: Q
authors.lastname: Jing
authors.affiliation: Department of Dermatology, Peking Union Medical College Hospital, 100730 Beijing, China.
authors.forename: Qiu-ning
authors.initials: QN
authors.lastname: Sun
authors.affiliation: Department of Dermatology, Peking Union Medical College Hospital, 100730 Beijing, China.
authors.forename: Hong-wei
authors.initials: HW
authors.lastname: Wang
authors.affiliation: Dental Department.
authors.forename: Ji-zhi
authors.initials: JZ
authors.lastname: Zhao
authors.affiliation: Dental Department.
authors.forename: Lin
authors.initials: L
authors.lastname: Ma
authors.affiliation: Dental Department.
authors.forename: Ling-jia
authors.initials: LJ
authors.lastname: Kong
mesh_terms: D000293:Adolescent; D000328:Adult; D000698:Analgesia; D002648:Child; D062109:Dermatologic Surgical Procedures / Q000379:methods*; D005145:Face; D005153:Facial Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D009507:Nevus of Ota / Q000601:surgery*; D010525:Peripheral Nerves; D019339:Port-Wine Stain / Q000601:surgery*; D055815:Young Adult
keywords: cutaneous laser surgery; nerve block; pain